Food insecurity, CD4 counts, and incomplete viral suppression among HIV+ patients from Texas Children's Hospital: a...

Area of Science:

• Pediatric Infectious Diseases
• Nutritional Epidemiology
• Public Health

Background:

• Human Immunodeficiency Virus (HIV) infection remains a significant global health challenge, particularly in pediatric populations.
• Maintaining high CD4 counts and achieving viral suppression are critical indicators of successful HIV management.
• Food insecurity, a state of inconsistent access to adequate food, may negatively influence health outcomes in vulnerable populations.

Purpose of the Study:

• To investigate the association between food insecurity and immunological status (CD4 counts) and virological control (viral suppression) in pediatric patients living with HIV.
• To quantify the impact of food insecurity on key biomarkers of HIV disease progression and treatment efficacy.

Main Methods:

• A cross-sectional study design was employed, analyzing data from pediatric HIV-positive patients.
• Food insecurity was assessed using a validated survey instrument.
• CD4 counts and viral load data were retrospectively collected from electronic health records.
• Statistical analyses included linear regression for log-transformed CD4 counts and logistic regression for viral suppression, with backward covariate selection.

Main Results:

• Food insecurity was significantly associated with lower CD4 counts (β = -0.23, 95% CI [-0.40, -0.01]).
• Patients experiencing food insecurity had significantly higher odds of incomplete viral suppression (OR = 4.07, 95% CI [1.02, 13.92]).

Conclusions:

• Food insecurity represents a significant barrier to optimal health outcomes in pediatric HIV care.
• Interventions addressing food insecurity may be essential for improving CD4 counts and viral suppression rates in this population.
• Further research is warranted to explore causal pathways and develop targeted support strategies.